Surgical and Gynaecological Abdominal Emergencies in Adults: The Experience of Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria.

Ibrahim, NA; Oludara, MA; Omodele, FO; Oyedele, O.O.

doi:10.4314/nhp.v5i3-4.57845

Cited by 4 publications

(7 citation statements)

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“…In reports from institutions in this region and other parts of the world, surgery for acute appendicitis was the most frequent non-trauma emergency procedure [3,8,14,23,24] . Complicated hernia is the most frequent cause of intestinal obstruction in our practice, similar to finding in a previous report from our institution [7] . In Sierra-Leone, intestinal obstruction due to complicated hernia was the most common indication for emergency abdominal surgery [25] .…”

Section: Discussionsupporting

confidence: 91%

“…However, this pattern varies depending on geographical location and continues to change as a result of socio-demographic and environmental factors. For example, acute appendicitis which was thought to be infrequent among Africans is now the most common cause of acute abdomen in the West African sub-region [7,8] . Economic advancement has led to increasing intake of refined fibre-depleted diet which forms tenacious, firm and slow-moving faeces.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with trauma-related conditions are offered free medical treatment in the first 24 h. This privilege has not been extended to non-trauma emergencies. Although, few studies were carried out in the past on surgical emergencies in Lagos [3,7] , the present status of the hospital may present a new spectrum of diseases and challenges. It is, therefore, desirable, as we have aimed, to assess the spectrum/pattern of non-trauma surgical emergencies in our center, identify immediate challenges in management and evaluate outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care

Ibrahim

Oludara

Ajani

et al. 2015

Annals of Medicine &Amp; Surgery

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IntroductionSignificant deaths of between 21% and 38% occur from non-trauma surgical conditions in the accident and emergency room. Access to emergency surgical care is limited in many developing countries including Nigeria. We aimed to study the spectrum of non-trauma surgical emergencies, identify challenges in management and evaluate outcomes.MethodsA one year prospective cohort study of all non-trauma emergencies in adults seen at the surgical emergency room of LASUTH from 1st October, 2011 to 30th September, 2012 was conducted. Data was analyzed using SPSS version 15.0.ResultsOf a total of 7536 patients seen, there were 7122 adults. Those with non-trauma conditions were 2065 representing 29% of adult emergencies. Age ranged between 15 and 97 years and male to female ratio was 1.7:1. Acute abdomen (30%), urological problems (18%) and malignancies (10%) were the most common. Among 985 patients requiring admission only 464 (47%) were admitted while the remaining 53% were referred to other centers. Emergency surgical intervention was carried out in 222 patients representing 48% of admitted patients. There were 12 (24%) non-trauma deaths in the emergency room. They were due to acute abdomen and malignancies in half of the cases.ConclusionFacilities for patients needing emergency care were inadequate with more than half of those requiring admission referred. Attention should be paid to the provision of emergency surgical services to the teeming number of patients seen on yearly basis in the Teaching Hospital.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care

Ibrahim

Oludara

Ajani

et al. 2015

Annals of Medicine &Amp; Surgery

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“…Septic abortion with uterine perforation accounted for 7% of the gynecological emergencies in a study in Nigeria. 11 There was a similar finding in this study with almost 5% of unsafe abortion out of the total 314 cases. This number is also worrisome to us as abortion in Nepal has been legalized, and safe abortion is widely promoted.…”

Section: Discussionsupporting

confidence: 87%

“…6 The most common gynecological and obstetrical emergency encountered in this study was ectopic pregnancy, which is comparable with the findings in a teaching hospital in Nigeria, where ectopic pregnancy was the commonest indication for surgery. 11 Another study in Nairobi, Kenya also showed that ectopic pregnancy was the most common cause for emergency laparotomy among women. 12 A study however showed that, Pelvic Inflammatory Disease was the most common gynecological emergency in their district hospital at Kasur, Pakistan.…”

Section: Discussionmentioning

confidence: 99%

Surgical Emergencies in Obstetrics and Gynaecology in a Tertiary Care Hospital

Pokharel¹,

Dahal²,

Rai³

et al. 2013

J Nepal Med Assoc

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Introduction: The management of Obstetrics and Gynaecological Emergency is directed at the preservation of life, health, sexual function and the perpetuation of fertility. Main aim of the study was to access the burden of Surgical Emergency in Obstetrics and Gynaecology and their course of management at BPKIHS.Methods: A total of 314 women presenting at the emergency admission room of Obstetrics and Gynaecology Department of BPKIHS over two years, who required surgical intervention were included in this hospital based descriptive study. Clinical assessment and routine laboratory investigations were performed in all cases. All patients who presented with shock were resuscitated and surgery was done at earliest possible time.Results: The age of patients ranged from 15- 55 years with approximately 43% in the 25-34 years category. Ninety two percent of them were married. Among the unmarried, 64% came with problems related to unsafe abortion. About 61% of females presenting as acute surgical abdomen had ruptured ectopic pregnancy, 7.64% had twisted ovarian cyst, and 6.26% had haemoperitoneum and pyoperitoneum following vaginal hysterectomies, total abdominal hysterectomies and caesarean section. Almost half (47.8%) of the cases underwent salphingectomy.Conclusions:Women present with wide range of complaints and conditions in the admission room of Obstetrics and Gynecology department of BPKIHS. Skilled clinicians, immediate investigation facilities and experienced specialty Obstetrical and Gynaecological surgeons are the main backbone of the emergency case management and saving lives. Study indicates there is need of some prospective study to establish the causes of rising trend in Ectopic Pregnancies.Keywords: ectopic pregnancy; emergency; gynaecological; obstetrics.

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